PARKVIEW TRAUMA 2015 · 2019-10-24 · 2014* (n=1794) Note: Thirteen cases were not admitted; these patients either expired or transferred out from the Emergency Department. * Excludes

PARKVIEW TRAUMA 2015ANNUAL REPORT

I Research20

MISSION STATEMENT

OUR MULTIDISCIPLINARY TEAM IS DEDICATED TO THE TREATMENT OF VICTIMS

OF TRAUMA, THE EDUCATION OF THE COMMUNITY AND THE PREVENTION

OF INJURY. WE STRIVE FOR OPTIMAL OUTCOMES BY PROVIDING EFFICIENT,

QUALITY CARE, AND ARE COMMITTED TO SUPPORTING THE CAREGIVERS IN

THE CRISIS ARENA.

TABLE OF CONTENTS

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7

8

14

19

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25

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30

33

36

38

39

23

Parkview Adult and Pediatric Trauma Centers’ Annual Report was published in December 2015.

A DEMONSTRATION OF TEAMWORK

CLINICAL DEFINITIONS / RATING SCALES

REGISTRY

PEDIATRICS

GERIATRICS

TRAUMA SPECIALTIES

CRITICAL CARE

POST-TRAUMA CARE

PERFORMANCE IMPROVEMENT

RESEARCH

OUTREACH AND EDUCATION

COMMUNITY HOSPITALS

EMERGENCY PREPAREDNESS

PREVENTION

I A Demonstration of Teamwork4

In December 2014, the American College of Surgeons (ACS) returned to Parkview Regional Medical Center to conduct an objective, external review of Parkview Trauma Centers’ institutional capability and performance. These functions were accomplished with an on-site review by a peer review team experienced in the field of trauma care.

Much of the site review team’s time was spent reviewing

clinical care and performance improvement centered

on the injured patient. In addition, reviewers toured

the hospital and visited various departments to ask

questions and verify documentation.

The result of the two-day site visit: Re-verification of

Parkview Trauma Centers as Level II Adult and Pediatric

Trauma Centers for three years. It was a perfect

program review — without any deviations from the

ACS standard of care as outlined in the Resources for

Optimal Care of the Injured Patient.

This recognition by the ACS provides confirmation that

a trauma center has demonstrated its commitment

to providing the highest quality trauma care for all

injured patients. Re-verification also reflects broadly on

members of the trauma team, both those who provide

assessment and care to patients before they arrive at

the hospital and those who provide services within the

hospital walls.

Strengths of Parkview’s trauma program, as identified

during the ACS site review, include:

• Institutional commitment to the trauma program as

evidenced by dedicated resources and assumption of

a regional leadership role in trauma care.

• Implementation of an electronic data-monitoring

system for all vital issues, including patient care and

program administration.

• The physical plant, comprised of Parkview

Regional Medical Center (PRMC), including design

of the Emergency Department, Intensive Care

Unit and Surgery, results in staff efficiencies and

improved patient outcomes.

A DEMONSTRATION OF TEAMWORK

A Demonstration of Teamwork I 5

• Support from the PRMC Emergency Department,

which is staffed 24/7 by board-certified

emergency physicians.

• Support from the physicians and staffs of the

Imaging Department.

• Support from critical-care experts such as trauma

surgeons, orthopedic traumatologists, neurosurgeons,

cardiovascular surgeons and plastic surgeons.

• Expanse of outreach and education efforts, as well as

follow-up reporting to EMS and referring hospitals to

share patient outcomes with local providers.

• Commitment to research that impacts how care is

delivered locally and nationwide.

In 2000, Parkview was the first Indiana trauma center

outside Indianapolis to be verified as an adult trauma

center by the ACS. Verification as Indiana’s first pediatric

trauma center outside of Indianapolis followed in 2003.

Both programs have consistently been re-verified since

these dates.

In addition to re-verification, trauma prevention efforts

resulted in several milestones during the past year.

Parkview partnered with the American Orthopaedic

Association to educate geriatric patients on how to

prevent bone fractures. The trauma centers also worked

with Parkview LaGrange Hospital to refresh and expand

the Share the Road message, customizing it for a

growing Amish population in LaGrange County.

Parkview Adult and Pediatric Trauma Centers are

strong because of the commitment by each member of

the trauma team. From the pre-hospital phase through

inpatient care and the rehabilitation process, each team

member demonstrates commitment to accomplish

clinical excellence. This commitment provides the best

outcomes for injured individuals throughout the region.

0 10 20 30 40 50

47.9

26.2

8.9

4.9

4.8

0.7

0.3

0.3

0.2

0.1

Percentage Distribution

ER Disposition, All Ages2014

General Floor

Intensive Care Unit

Operating Room

Direct Admit

Pediatric Floor

Pediatric ICU

Death

Transport Out

ED Clinical Decision Unit

Neonatal ICU

Home

Coronary Care Unit

# of Cases

866

474

160

103

89

86

12

6

5

3

2

1

Dep

artm

ent

5.7

0.1

I A Demonstration of Teamwork6

0 200 400 600 800 1,000 1,200 1,400

1,282

285

153

15

13

12

9

8

6

2

2

2

2


Admission Service*, All Ages2014* (n=1794)

Note: Thirteen cases were not admitted; these patients either expired or transferred outfrom the Emergency Department.* Excludes 287 cases with isolated hip fractures.

Trauma Service

Orthopedic Surgery

Hospitalist Service

Pediatric Critical Care

Cardiology

Neurosurgery

Pediatrics

Family Practice

Internal Medicine

Urology

Oncology

Eye Surgery

Cardiac Surgery

Oral Surgery

Pediatric General Surgery

Plastic Surgery

1

1

1

A DEMONSTRATION OF TEAMWORK continued

Clinical Definitions / Rating Scales I 7

What qualifies as a trauma?

Trauma resulting in injury may be characterized by

abnormal energy transfer involving mechanical energy

(moving objects), thermal, electrical, chemical and

radiation; the catastrophic injuries arising from automobile

crashes are the result of transfer of energy between the

victim and a stationary object (the ground) or a moving

object (another vehicle).

Who is a trauma patient?

Trauma patients include individuals with an injury

diagnosis of ICD-9 codes 800.00 – 959.90, excluding

ICD-9 codes 905 – 909 (late effects of injuries) and

930 – 939 (foreign bodies entering through orifice).

Injury Severity Score (ISS)

Injury Severity Score is an anatomical scoring system

designed to provide an overall score for trauma patients

with multiple injuries. The Injury Severity Score is the sum

of squares of the three highest abbreviated injury scale

scores for injuries to different body regions (head/neck,

face, thorax, abdomen and pelvic contents, extremities

and external).

ISS takes values from 0 to 75 and correlates with

mortality, morbidity and hospital length of stay.

Glasgow Coma Scale (GCS)

The Glasgow Coma Scale is a standard measure to

quantify level of consciousness in head injury patients. It

is composed of three parameters: best eye response (4),

best verbal response (5) and best motor response (6).

The lowest GCS total is a 3 and the best score is a 15.

CLINICAL DEFINITIONS

RATING SCALES

A trauma registry is an electronic database with uniform data elements that describe the injury event, demographics, pre-hospital information, diagnosis, care, outcomes and costs of treatment. The database is used to collect, organize and analyze information on trauma patients and is essential to providing trauma service.

The data have many uses but are primarily used to

monitor the continuum of care, from injury prevention to

outcomes measurement. Currently, the Parkview trauma

registry manages data for more than 35,000 patients.

The Parkview trauma registry contributes information

to the National Trauma Data Bank, the Indiana

State Department of Health and the Trauma Quality

Improvement Project (TQIP) on a regular basis. This

contribution to a larger database allows Parkview

to identify trends in quality measurements, shape

public policy and benchmark at national, state and

regional levels.

The expedient disposition of patients from the Emergency Department to Surgery has tremendous bearing on patient outcomes. Related data is tracked by the Parkview trauma registry.

I Registry8

REGISTRY

REGISTRYREGISTRY

Registry I 9

REGISTRYREGISTRY

58.7%

41.3%

68.6%

31.4%

43.6%

56.4%

M

Age and Gender, All Patients2014

Ages of All Patients2014

0 – 16

17 – 44

45 – 64

>64

32.4%

12.7%

24.9%

30%

0 - 16 Yrs. 17 - 64 Yrs. > 65 Yrs.

F

Mode of Transport for Patients to Parkview Trauma Centers2014

Air

Ambulance

Private

Unknown

15.3%14.9%

69.0%

0.9%

I Registry10

Fall

Motor Vehicle Crash

Motorcycle/Moped Crash

Other

Bicycle Crash

Gunshot Wound

Machinery

Assault

Sporting Injury

Animal Attack

ATV Crash

Pedestrian Struck

Stabbing

Buggy Crash

Sled/Snow

Skateboard

Other Vehicle

Explosion

Child Abuse

Farm Machine

Drowning/Near Drowning

Hanging

Dive

Explosion

Burn

Skiing

Sexual

Poison

Industrial

Electricity

Boat Craft

0 5 10 15 20 25 30 35 40 45 50

43.7

25.8

5.4

5.1

2.2

1.9

1.7

1.6

1.5

1.4

0.5

0.4

0.3

0.3

0.3


Mechanism of Injury, All Ages2014*

0.3

0.2

0.2

0.2

0.2

0.1

0.1

0.10.1

0.1

0.1

0.1

# of Cases

790

466

93

96

41

39

35

35

30

29

27

25

9

8

6

5

5

5

5

4

4

3

3

2

2

1

1

1

1

1

1

Note: There were 34 cases with unknown mechanism of injury.

0.1

0.3

1.9

2.3

* Excludes 287 cases with isolated hip fractures.

Registry I 11

All Trauma ER-ICU/PICU ER-Surgery

Volume of All Ages Admitted from ER to ICU and OR2010 – 2014

2010

2011

2012*

2013*

2014*

1,821

121460

1,831

153387

1,779

196404

1,807

160474

1,884

175360


0 200 400 600 800 1,000 1,200 1,400 1,600 1,800 2,000

98.4%

1.6% 0.5% 2.7%

All TraumaBlunt Trauma

PenetratingTrauma

Trauma Type2014

0 - 14 Yrs. > 65 Yrs. All Patients

99.5%97.3%

I Registry12

1,25170

1,40557

GCS 3-8 GCS 9-13 GCS 14-15

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

GCS 3-8 = Possible severe head injury

GCS 9-13 = Possible moderate head injury

GCS 14-15 = Possible mild head injury

Volume (and Percentage) of All Patients by Admit Glasgow Coma Score (GCS) Value2010 – 2014*

1,49879

1,41271156

1,449571452011

2010

2012

2013

125

98

138

2014

* Excludes cases for which GCS is unknown.

1,498267

1,617249

1,532280

1,541268

1,519250

ISS > 15 ISS < 15

Volume (and Percentage) of All Ages by Injury Severity Score (ISS) Value2010 – 2014*

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

ISS > 15 can include life-threatening, critical or fatal injuries.

2014

2012

2010

2013

2011

* Excludes cases for which ISS is unknown.

13Registry I

0 400 800 1,200 1,600 2,000 2,400

All Trauma Trauma Services Patients

2,0941,304

1,884967

1,779893

1,8211,065

1,831860

Trend of Trauma Admission by Type2010 – 2014

2010

2014

2013

2011

2012


Volume of All Ages Admitted from ER to ICU and OR2010 – 2014

2010

2011

2012*

2013*

2014*

1,821

121460

1,831

153387

1,779

196404

1,807

160474

1,884

175360


0 200 400 600 800 1,000 1,200 1,400 1,600 1,800 2,000

PEDIATRICS

Children experience trauma differently than adults due to significant anatomical and physiological differences, as well as varying mechanisms and patterns of injury. This requires a unique response to major trauma in children, which drives a need for specialized pediatric services. Parkview Regional Medical Center is verified as a pediatric trauma center by the American College of Surgeons, and is dedicated to providing the resources necessary to accommodate the specialized needs of the pediatric trauma population. Verification is granted to trauma centers that demonstrate the highest quality of care, in addition to a commitment to injury prevention, outreach, performance improvement and education.

More children die from injury than from all other causes

combined. For injured children who survive, severe

disability may become a lifelong problem:

• Drastically affecting their quality of life

• Requiring multiple surgeries and/or long-term care

• Impacting their families’ financial well-being

• Further adding to societal healthcare costs

Parkview provides effective care to each injured child

through a comprehensive and inclusive approach that:

• Recognizes childhood injury as a major public

health concern

• Identifies effective strategies for prevention

I Pediatrics14

Pediatric nurse Kelly Vandemark, RN, puts a young patient at ease. The Parkview Pediatric Trauma Center draws on the expertise of many specialties in the triage and treatment of pediatric patients.

Pediatrics I 15

• Improves systems of emergency medical care

for children

• Provides the highest-quality pediatric trauma care,

including rehabilitation care

As a pediatric trauma center, Parkview has special

resources dedicated to the care of injured children. The

high quality of pediatric trauma care at Parkview can

be attributed to the pre-hospital providers, physicians

and hospital-based personnel who support the trauma

program. All members of the trauma team are committed

to pediatric trauma care, and all members of the trauma

team who care for injured children are appropriately

trained and credentialed. For the pediatric patient, there

is active collaboration with other surgical and pediatric

subspecialists, such as neurosurgeons, orthopedic

surgeons, pediatric emergency medicine physicians and

pediatric critical care physicians.

Parkview Trauma Centers continue to host the

annual Pediatric Trauma Symposium and coordinate

site visits to the simulation lab at Cincinnati’s

Children’s Hospital Medical Center in Cincinnati, Ohio.

Members of the pediatric trauma team participate

in bi-monthly pediatric simulations hosted by

Parkview’s Trauma Center. Additionally, the trauma

program is collaborating on the development of a

Child Maltreatment Response Team and supports the

Child Abuse Symposium to increase awareness and

prevention of child maltreatment. These efforts support

a high level of trauma expertise among the regional

system of providers who care for injured children.

I Pediatrics16

GRAPHS

0 10 20 30 40 50 60

51

12

6.3

4.7

4.7

4.7

2.6

2.1

2.1

1.6

1.6

1

1

1

0.5

0.5


Mechanism of Injury, Pediatric Patients (Ages 0 - 14)2014

0.5

Note: There was one case with unknown mechanism of injury.

0.5

Fall

Motor Vehicle Crash

Other

Sport-related Injury

Bicycle Crash

Animal-Related Injury

Child Abuse

Drowning/Near Drowning

ATV Crash

Motorcycle

Machinery

Pedestrian

Gunshot Wound

Buggy Crash

Skateboard

Sexual Abuse

Poisoning

Other Vehicle

Farming

Assault

# of Cases

98

23

12

9

9

9

5

4

4

3

3

2

2

2

1

1

1

1

1

1

0.5

0.5

1392.01

0 1 2 3 4

2014

2013

2012

2011

2010

Mean ICU LOS (Days)

91

70

69

69

83

2014

2013

2012

2011

2010

Total ICU Days

0 100 200 300

2.46

2.80

174

ICU Length of Stay (LOS), Pediatric Trauma (Ages 0 - 14)2010 – 2014

1.97

2.62

179

232

181

# of Cases

17

Note: Excludes patients who expired in the Emergency Department or were transferred out of the Emergency Department.

2.1 397

2.1 4022.4 382

0 100 200 300 400 500 600

Hospital Length of Stay (LOS), Pediatric Trauma (Ages 0 - 14)2010 – 2014

2.8 470

2.5 463

2014

2013

2012

2011

2010

Mean Hospital LOS (Days) Total Hospital Days0 2 4

# of Cases

2014

2013

2012

2011

2010

191

163

196

188

168

111613

1311017

GCS 3-8 GCS 9-13 GCS 14-15




Volume (and Percentage) of Pediatric Patients (Ages 0 - 14) by Admit Glasgow Coma Score (GCS) Value2010 – 2014*

14096

1211011

145811

2014

2011

2010

20122013

* Excludes cases for which GCS is unknown.

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Pediatrics I

I Pediatrics18

2014

2012

2010

2013

2011

16120

17716

14219

16317

15418

ISS > 15 ISS < 15

Volume (and Percentage) of Pediatric Patients (Ages 0 - 14) by Injury Severity Score (ISS) Value2010 – 2014

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%



Volume of Pediatric Patients (Ages 0 - 14) Admitted from ER to ICU or Surgery2010 – 2014

2013 163

1152

2010 174

2160

2014 192

1474

2011 190

1750

2012 196

2149

150 200 250100500

19Geriatrics I

GERIATRICS

Jason Heisler, DO, orthopedic trauma medical director and orthopedic surgeon with Ortho NorthEast; and Tabitha Bane, NP, geriatric fracture coordinator, Parkview Trauma Centers, collaborate on the geriatric fracture program.

Fragility fractures are the first sign of poor bone health. In recent years, the occurrence of fragility fractures has become nearly epidemic among older adults in the United States, with more than two million fractures diagnosed annually — more than heart attacks, strokes and breast cancer cases combined. The statistics are alarming:

• Up to one-half of all women and one-quarter of all

men will suffer fragility fractures in their lifetimes.

• Nearly 25 percent of patients who suffer a hip

fracture die within a year. Those who do survive often

experience a loss of independence and may require

long-term nursing home care.

• At least 44 million Americans are affected by

osteoporosis or low bone density.

• Approximately 80 percent of patients do not receive

recommended osteoporosis care following a fracture.

• One of the best indicators for a future fracture is a

previous fragility fracture. Patients who have had a

fragility fracture are at an 86 percent higher risk of a

second fracture.

As sentinel events, fragility fractures provide

opportunities for physicians to educate patients, fellow

physicians and other healthcare professionals. The

seriousness of the fracture episode provides physicians

with a “teachable moment” in which it is possible to

impact behavior and treatment.

Parkview has partnered with the American

Orthopaedic Association’s “Own the Bone®” program

in bridging the gap between osteoporosis and fragility

fracture care. Own the Bone serves to identify, evaluate

and treat fragility fracture patients through use of a

national web-based registry, collaborating physicians

and a fracture-care liaison to facilitate both inpatient

and outpatient care. Through Own the Bone partnership,

Parkview recognizes the specialized needs of this

population of patients as well as the positive impact

offered through initiating a geriatric fracture program.

Own the Bone® is a registered trademark of the American Orthopaedic Association.

I Geriatrics20

Fall

Motor Vehicle Crash

Other

Bike

Motorcycle/Moped

Pedestrian Struck

Machinery

Gunshot Wound

Assault

Stabbing

Other Vehicle

Explosion

Buggy

Animal Attack

74.4

15.7

1.4

1.2

0.9

0.3

0.3

0.2


Mechanism of Injury, Geriatric Patients (Ages _> 65)2014*

# of Cases

435

92

9

8

7

5

4

2

2

1

1

1

1

1

Note: There were 16 cases with unknown mechanism of injury.

* Excludes geriatric cases with isolated hip fractures.

0 10 20 30 40 50 60 70 80

1.5

0.7

0.2

0.2

0.2

0.2

6354.85

0 2 4 6 8

2014*

2013*

2012*

2011

2010

Mean ICU LOS (Days)

209

157

131

115

126

2014*

2013*

2012*

2011

2010

Total ICU Days

0 200 400 600 800 1,000

3.98

4.17

625

ICU Length of Stay (LOS), Geriatric Trauma (Ages _> 65) 2010 – 2014

4.06 848

525

492

# of Cases

4.28


21Geriatrics I


4.7 2,694

5.1 2,669

4.9 2,255

0 2 4 6 0 1,000 2,000 3,000 4,000

Hospital Length of Stay (LOS), Geriatric Trauma (Ages _> 65)2010 – 2014

5.0 2,921

5.0 3,158

2014*

2013*

2012*

2011

2010

Mean Hospital LOS (Days) Total Hospital Days # of Cases

2014*

2013*

2012*

2011

2010

588

626

523

46

457

9



Volume of Geriatric Patients (Ages _> 65) Admitted from ER to ICU or Surgery2010 – 2014

464

16116

592

2280

585

27

631

23

523

1979

2010

2011

2012*

2013*

2014*172

0 100 200 300 400 600500 700


67

I Geriatrics22

4883021

4692726

3731729

2018

GCS 3-8 GCS 9-13 GCS 14-15




Volume (and Percentage) of Geriatric Patients (Ages _> 65) by Admit Glasgow Coma Score (GCS) Value2010 – 2014

4391319

2011

2010

2012*

2014*

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

2013*

475


2014*

2012*

2010

2013*

2011

46358

49981

40856

56169

53059

ISS > 15 ISS < 15

Volume (and Percentage) of Geriatric Patients (Ages _> 65) by Injury Severity Score (ISS) Value2010 – 2014


0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%


Trauma Specialties I 23

TRAUMA SPECIALTIES

For a health system to maintain a successful trauma center, specialty physicians must take an active role in providing optimal care to the injured patient. The roles of the trauma surgeons, emergency medicine physicians, orthopedic surgeons, plastic surgeons and neurosurgeons have been defined by the American College of Surgeons (American College of Surgeons: Committee on Trauma, 2014). The team approach of specialty surgeons is available at Parkview Regional Medical Center 24 hours a day, seven days a week to ensure the highest level of comprehensive care for our injured patients.

Neurosurgery

Nationwide, traumatic brain injuries (TBIs) account

for more than 500,000 hospitalizations and result

in more than 175,000 significant disabilities. Close

to 40 percent of all deaths related to acute trauma

are caused by TBIs, with this percentage gradually

decreasing over the past few years due to clinical and

laboratory research (American College of Surgeons:

Committee on Trauma, 2014).

Active neurosurgical participation is crucial for the

injured patient and requires successful planning and

implementation. The neurotrauma care at Parkview

Regional Medical Center is organized by a highly

experienced team of six board-certified neurosurgeons,

who are available 24/7 to ensure effective neurotrauma

care for all traumatic brain injured patients, as well

as cervical spine stabilization and treatment. The six

neurosurgeons are led by a devoted neurosurgery

trauma liaison, James Dozier, MD, Fort Wayne

Neurological Center.

In 2014, Neurosurgical Services collaborated in the

care of 524 traumatically injured patients admitted at

Parkview Regional Medical Center (PRMC).

Orthopedic Surgery

Close to 50 percent of all hospitalized trauma patients

have one or more musculoskeletal injuries. These

injuries can be life- or limb-threatening and may result

in significant functional impairment (American College

of Surgeons: Committee on Trauma, 2014).

Parkview Regional Medical Center offers the latest

technologies, readily available operating rooms, and

a well-trained, highly experienced staff to care for

musculoskeletal trauma. PRMC offers 15 experienced

orthopedic surgeons with additional specialty board

certification training in hand and wrist, foot and ankle,

and spine trauma treatment, as well as two specialty

trained board-certified trauma orthopedic surgery

specialists. The trauma orthopedic specialty services

are available around the clock, seven days a week, at

PRMC and are led by David Goertzen, MD, and Jason

Heisler, DO, both of Ortho NorthEast.

In 2014, orthopedic surgeons collaborated in the care of

927 traumatically injured patients admitted at PRMC.

Plastic Surgery

Comprehensive traumatic wound and laceration

treatment is available at Parkview Regional Medical

Center through collaboration with six board-certified

plastic surgeons.

In 2014, plastic surgery collaborated in the care of

162 traumatically injured trauma patients admitted

at PRMC.

Reference:

American College of Surgeons: Committee on Trauma. (2014). Resources for Optimal Care of the Injured Patient.

17

At Parkview Regional Medical Center (PRMC), critical care is provided to trauma patients within the Surgical Trauma Intensive Care Unit (STICU). By responding to trauma activations, STICU nurses are a part of the hospital-based trauma team from the beginning of a patient’s arrival. Nurses work in partnership with the emergency room, operating room and diagnostic services to achieve the goal of providing early comprehensive resuscitation for trauma patients. Vital responsibilities in the ER include assisting with initial patient stabilization and assessment, obtaining critical lab results and assisting with procedures. To support a seamless care transition, the ICU nurse then assists with transport of a patient to the ICU.

Environmental design and technology address

the critical needs of trauma patients. STICU has

technology that allows staff to monitor multimodal

invasive hemodynamic pressure, brain pressure,

intravascular or surface warming or cooling, continuous

dialysis, mechanical rotation, and massive transfusion

resuscitation. The ICU rooms are large enough for

in-room surgery or resuscitation, if needed. Space design

promotes a quiet atmosphere, allowing patients and

their loved ones to experience care in a therapeutic

healing environment.

Bedside nurses from STICU are dedicated to continual

professional development in order to enhance the

outcomes of their trauma patients. This is accomplished

by participating in educational opportunities planned

and presented by Trauma Services team members, as

well as simulation events provided within the hospital

and at the Parkview Center for Advanced Medical

Simulation. This critical-care training further develops

the skills of STICU nurses. The nursing team is actively

working with the Trauma Services Department on

performance improvement initiatives.

Here at PRMC, our care team of board-certified trauma

surgeons, anesthesiologists and other specialists are

available to provide rapid diagnosis and immediate

treatment of life-threatening injuries. A variety of

specialists are on-call to respond to the needs of

trauma patients, including orthopedic trauma surgeons,

neurosurgeons and other medical experts. Patients may

be admitted to the trauma ICU from the emergency

room, operating room, or another floor of the hospital.

Rounding involves the trauma provider team, patient

nurse, trauma case manager, rehabilitation therapy,

pharmacy, nutrition and respiratory departments to

assure that the patient progresses toward goals.

I Critical Care24

CRITICAL CARE

25Post-Trauma Care I

POST-TRAUMA CARE

Parkview Rehabilitation Center provides a full range of inpatient, therapeutic services and programs for patients ages six and older. As an integral part of the trauma care continuum available through Parkview’s verified Level II Adult and Pediatric Trauma Centers, the acute-care rehabilitation center is well equipped to treat patients who have a wide range of traumatic injuries, as well as neurological conditions and diseases.

Quality and expertise

Committed to providing excellent patient care, the

rehabilitation center:

• Is accredited by The Joint Commission

• Has consistently received certification for its

comprehensive inpatient, brain injury and stroke

programs from CARF, the Commission on

Accreditation of Rehabilitation Facilities

• Offers the added expertise of:

> Certified rehab registered nurses

> Staff members certified as brain injury specialists

> Therapy staff members certified in neuro

developmental treatment (NDT)

> Staff members certified in the use of VitalStim®

therapy for dysphagia, or difficulty swallowing

Parkview Rehabilitation Center offers patients huge

advantages over other rehabilitation facilities in the region:

• Location on a dedicated floor inside Parkview Hospital

Randallia, an acute-care hospital.

• On-site availability of any medical services required

during the patient’s stay – such as CT scans and other

diagnostic procedures, wound care or constant care. The

skilled medical specialists of this acute-care hospital are

readily available to assist in patient care as needed. If

there are critical needs, the rehab physician and consulting

physicians will identify the appropriate level of care.

VitalStim® is a registered trademark of Empi, Inc.

POST-TRAUMA CARE continued

Continuity of care

Physicians who have treated a patient prior to his or

her admission to the rehab program may continue to

participate in care along with the rehab team.

The rehab team includes medical professionals from

many different specialty areas. In a well-coordinated

process, these physicians, nurses, therapists and other

staff members provide intensive therapies with 24-hour

rehabilitation nursing care. The patient and family are

integral members of the team. This approach helps

patients maximize their highest level of ability during

recovery from illness or injury.

Accreditation

Parkview Rehabilitation Center meets rigorous

national standards as evaluated by The Joint

Commission and CARF. Earning accreditation is an

exacting process, and the Parkview Rehabilitation

Center strives to continually meet and exceed

recognized quality standards. Patient families can be

confident that the professionals providing care at the

center are focused on helping their loved ones achieve

the most favorable results possible.

Parkview Rehabilitation Center has been accredited by

CARF for the following programs:

• Brain Injury program (child/adolescent and adult)

• Comprehensive Inpatient Medical Rehabilitation

program (child/adolescent and adult)

• Stroke program

The Comprehensive Inpatient Medical Rehabilitation

program received initial accreditation in 1978 and has

been re-accredited for each period since then. The

Brain Injury program received initial accreditation in

1988 and has been re-accredited for each period since

then. The Stroke program was the first reviewed by

CARF in 2009.

I Post-trauma Care26

27Performance Improvement I

PERFORMANCE IMPROVEMENT

In the PIPS model, a trauma center is required

to continuously monitor, assess and manage the

environment in which care is given, the trauma care

itself and the patient outcomes that follow. This is

accomplished by concurrent and continuous extensive

chart review, multiple levels of peer review and

multidisciplinary meetings that review all of the aspects

related to trauma care.

The PIPS program is supported by a trauma registry of

concurrent data collection that obtains the necessary

information to identify opportunities for improvement.

The data collection allows the PIPS program to monitor

and continually improve internal and external structures,

processes and outcomes.

Trauma Performance Improvement and Patient Safety

According to the American College of Surgeons

Committee on Trauma (2014), all trauma centers

should provide safe, efficient and effective care to the

injured patient. Doing so will require the authority and

accountability to reduce unnecessary variations in care

and prevent adverse events.

The Adult and Pediatric Trauma Centers, located at

Parkview Regional Medical Center, have adopted the

modern Performance Improvement and Patient Safety

(PIPS) model for measuring quality. The PIPS model

(below) includes a continuous and concurrent process of

monitoring, assessing and managing trauma care using a

multidisciplinary effort to measure, evaluate and improve

the process of care and its outcomes. Performance

improvement and patient safety are inseparable. The

performance improvement process is directed at the

care itself, and the patient safety process is directed at

the environment in which the care is given.

Instruction

Modification Analysis

Data Collection

Assessment

RecognitionCorrection

19

Process Measures

Process measures include:

• Compliance with guidelines, protocols and pathways

• Appropriateness of triage by pre-hospital providers and the Emergency Department

• Delay in assessment, diagnosis, technique or treatment

• Timeliness and availability of imaging reports

• Judgment, communication and treatment

• Completeness of documentation

• Professional behavior

Corrective Measures

Corrective measures include:

• Guideline, protocol or pathway revision or development

• Targeted education

• Enhanced resources, facilities or communication

• Peer review presentations

• Multidisciplinary presentations

• External review

Outcomes Measures

Outcomes measures include:

• Mortality

• Morbidity

• Length of stay in the Emergency Department, ICU and overall

• Cost

• Quality of life

Reference:

American College of Surgeons: Committee on Trauma. (2014).

Resources for Optimal Care of the Injured Patient.

PERFORMANCE IMPROVEMENT continued

I Performance improvement28

29Performance Improvement I

2,600

3.80

0 2 4 6

2014

2013

2012

2011

2010

Mean ICU LOS (Days)

676

590

529

505

565

2014

2013

2012

2011

2010

Total ICU Days

0 500 1,000 1,500 2,000 2,500 3,000

4.36

4.14

2,575

2,146

ICU Length of Stay (LOS), All Ages2010 – 2014

3.75

4.91

2,093

# of Cases

2,533


4.0 7,179

4.6 7,618

4.5 6,871

0 2 4 6 0 2,000 4,000 6,000 8,000 10,000


Hospital Length of Stay (LOS), All Ages2010 – 2014

4.6 8,110

4.5 8,383

2014*

2013*

2012

2011

2010

Mean Hospital LOS (Days) Total Hospital Days

# of Cases

2014*

2013*

2012

2011

2010

178

915

5816

98

186

217

50

Research is a vital activity of the Parkview Trauma Centers because of its implications for quality patient care, proper utilization of healthcare services within the hospital setting, quality registry data and prevention efforts.

Parkview has engaged in trauma research since initial

verification as a Level II trauma center in May 2000.

Parkview Adult and Pediatric Trauma Centers are

among the elite few trauma centers nationwide whose

staffs include a trauma epidemiologist and a data

specialist with master’s degree-level training in public

health. Together, this research team is dedicated to

data validation and tracking trends related to

traumatic injury.

Within this report, we highlight two research projects.

Project 1: Effectiveness of the Rural Trauma Team Development Course (RTTDC©) for Educating Nurses and Other Healthcare Providers in Rural Community Hospitals

Parkview Adult and Pediatric Trauma Centers have

been providing RTTDC education to raise the standard

of trauma care at rural hospitals since November 2011.

In the year under report, further data analysis on the

RTTDC research project was done to assess the early

transfer of trauma patients from rural emergency

departments at the four Parkview community hospitals

(PCHs) to Parkview Trauma Centers (PTC).

We used a pre- and post-study design by querying

the trauma registry, as well as Allscripts™ ED data

that were transferred out from PCHs to PTC within six

months before and after RTTDC education (six-month

pre-/post-education group) and 12 months before and

after education (12-month pre-/post-education group).

Emergency Department time (EDT) was obtained from

Allscripts and used as a primary measure to indicate

the time from patient arrival at a community hospital

to the time of decision to transfer to PTC. EDT is an

appropriate indicator for early transfer from referring

hospitals to a verified trauma center. However, there

may be a waiting time in which communication occurs

between the trauma center and transport agency

before actually transferring out the patient. We

therefore also used the ED length of stay (LOS) at the

referring hospital as a proxy measure to assess early

transfer to the trauma center in question.

The overall reduction of 21.7 minutes of EDT and 18.5

minutes of ED LOS were observed in the six-month

group, and 21.6 minutes of EDT and 20.4 minutes of

ED LOS in the 12-month pre-/post-education group.

After controlling for covariates, there was a significant

reduction of 28 minutes in EDT (95% CI: -57, -0.1) in

RESEARCH

I Research30

Left to right:Dazar Opoku, MPH, Trauma Data Specialist, Trauma Services, Parkview Regional Medical CenterThein Hlaing Zhu, MB BS, DPTM, FRCP, FACE, Trauma Epidemiologist, Trauma Services, Parkview Regional Medical Center

31Research I

the six-month group and 29 minutes (95% CI: -53,

-6) in the 12-month education group. (See the table

below.) In using the ED LOS as the indicator, there was

a non-significant reduction of 29 minutes (95% CI: -60,

+2) in the six-month group and a significant reduction

of 43 minutes (95% CI: -72, -14) in the 12-month

education group.

Improved knowledge and experience in rural trauma

care among healthcare providers through the provision

of RTTDC education reduces either the EDT or ED LOS.

The research findings from the project were presented

as a poster at the fifth annual American College of

Surgeons (ACS) TQIP conference in Chicago, Ill., in

November 2014.

Project 2: Assessment of Hospital Cost at a Level II Trauma Center

Studies on trauma care cost have mostly been conducted

at the state level and at Level I trauma centers, but rarely

at a Level II trauma center. The purpose of this study was

to determine hospital cost for trauma patients by patient,

injury characteristics, mechanism of injury and payment

source at a Level II trauma center. The study also looked

at various factors influencing trauma care cost and which

payer sources provided the highest reimbursement for

trauma care.

Multiple Linear Regression Analysis for Predictors of EDT at Referring Hospitals

Intercept 23.5 -124.0, 171.0 -209.4 -503.4, 84.64

Education (Pre- vs. Post-) - 28 - 57, -0.1 -29 -53, - 6

TTA (No vs. Yes) - 42 - 76, -7 -52 -80, -24

EMS Time 0.8 -0.1, 1.7 1.3 0.6, 2.0

Age, Years (< 55 vs. ≥ 55) 45 14, 77 22 -3.0, 48

6 Months Pre-/Post-RTTDC Education 12 Months Pre-/Post-RTTDC Education

Reduction/Increase 95% CI Reduction/Increase 95% CI

RTTDC = Rural Trauma Team Development Course CI = Confidence Interval EMS time = Time in minutes taken by EMS from notification to hospital arrival TTA = Trauma Team Activation

I Research32

RESEARCH continued

The project was approved by the Parkview Health

Institutional Review Board. Data were queried from

the trauma registry from 2011 to 2013. Financial data of

total cost per patient were provided by the Parkview

Health Finance Department and were linked to the

trauma patients. The data were analyzed using SPSS

(Statistical Package for Social Science) software

version 22.

The mean and median costs were significantly higher

for patients who died in the hospital, despite their

shorter lengths of stay (LOS) relative to those of the

patients who survived. There were more male patients

with higher costs compared to females. The average

LOS was about the same for both males and females.

Falls were the most prevalent mechanism of injury,

but road trauma accounted for the highest mean and

median patient cost. Gunshot wound, stab wound

and other mechanism of injury produced lower costs

than fall and road trauma. (See table below for cost by

mechanism of injury.)

Medicare, besides other categories, was the most

common payer source for every year, followed by

self-pay, Medicaid, Blue Cross and Signature Care.

The mean ± standard deviation cost per patient over

the years was $15,135 ± $18,811 and the median and

interquartile range were $9,491 and $5,929 – $16,068.

This was a preliminary study. Further data analysis is

in progress. The research findings were presented as

a poster at the 27th annual MAHE Student Research

Fellowship Program conference held at Indiana

University–Purdue University Fort Wayne on

August 6, 2014.

Mean and Median Cost by Mechanism of Injury, 2011 – 2013

Mechanism of Injury No. of Patients

Patient Actual Cost Mean Median Total

Fall 2,072 $13,388 $9,190 $26,964,102

Road Trauma 1,898 $18,146 $10,537 $33,333,485

Violence (Gunshot/Stabbing) 222 $12,784 $9,429 $ 2,671,831

Others 652 $12,529 $8,001 $9,180,227

33Outreach and Education I

A verified trauma center is one component of a trauma

system — the broad network of emergency medical

providers, firefighters and law enforcement personnel

who care for individuals with life-threatening injuries.

The Parkview Trauma Centers have a robust outreach

program designed to enhance the quality of trauma

patient care by supporting ongoing clinical education

for members of the trauma system.

Parkview provides both instruction and hosts

educational opportunities featuring industry experts.

Trauma-related educational events are presented

throughout the year to area community hospitals,

fire departments and emergency medical services

providers. These courses are offered at each group’s

location. Presentations are customized to the

audience, with the objective of improving the care of

injured people. Since 1989, Parkview Trauma Centers

have provided trauma-related education to area

physicians, nurses, pre-hospital providers and other

allied health providers.

The learning events have been held at organizations in

30 counties across northeast Indiana, northwest Ohio

and south-central Michigan. More than 1,000 providers

participated in trauma-related education in 2014.

In November 2011, Parkview Trauma Centers began

offering a trauma team-building course called the

Rural Trauma Team Development Course (RTTDC©)

OUTREACH AND EDUCATION

to area community hospitals. The course was created

by the American College of Surgeons Committee

on Trauma via the Ad Hoc Rural Trauma Committee.

The goal of this education is to better equip clinical

and emergency services personnel to provide quality

trauma care in the rural setting. Since 2011, more than

300 providers from 14 rural hospitals have successfully

completed the course.

In February 2011, Parkview Trauma Services began

offering the Advanced Trauma Care for Nurses (ATCN)

course. This clinically intensive course, created

by the Society of Trauma Nurses, is offered annually in

conjunction with the Advanced Trauma Life Support

Course for physicians. Since 2011, 72 emergency

department, intensive care unit, operating room

and flight nurses have successfully completed our

ATCN course.

Other ongoing education programs include:

• Annual Trauma Symposium in May highlights a variety

of topics related to trauma care of adults and children.

• Annual Pediatric Trauma Symposium in November

focuses solely on care of the injured child. The

intended audience includes the entire team of

healthcare professionals who care for injured children.

• Trauma Grand Rounds is a live monthly educational

event open to the region’s healthcare providers

who are interested in developing their knowledge of

trauma care. Trauma cases from the previous month

are reviewed to celebrate trauma team success and

identify opportunities for improvement.

• Monthly trauma case studies review all aspects of

care, from triage at the trauma scene to discharge

from the trauma centers. The case studies enable

participants to earn continuing education credit.

• Trauma simulations are presented monthly to provide

a realistic training experience using high-fidelity adult

and pediatric human patient simulators to practice

trauma care under controlled conditions without lives

being at stake. The focus is on teamwork, as well as

on clinical care. More than 300 physicians, nurses,

patient care technicians and pre-hospital personnel

participated in 2014.

• Pre-hospital Skills Workshops offer monthly educational

offerings focused on the pre-hospital trauma provider.

These workshops provide an opportunity to maintain

and enhance the pre-hospital provider’s hands-on skill,

technique and knowledge.

• Trauma MD newsletters communicate Performance

Improvement and Patient Safety (PIPS) educational

material to physicians who care for victims of traumatic

injury at Parkview Trauma Centers.

• A robust trauma education extranet page offers

numerous trauma-related educational activities

and resources in multiple formats, including audio,

video, podcasts, webinars, images and links to

additional information.

• Follow-up letters are sent to pre-hospital personnel

and community hospital Emergency Department staff

members who cared for patients referred to Parkview

Trauma Centers. The purpose of these continuum-

of-care letters — which include identified injuries,

procedures and outcomes — is to aid in performance

improvement. More than 1,500 follow-up letters were

sent to providers in 2014.

OUTREACH AND EDUCATION continued

I Outreach and Education34 RTTDC© is a copyrighted program of the American College of Surgeons.

2014*

2012*

2010

2013*

2011

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

6171,081

7301,077

594964

6081,276

5901,189

Scene Transferred from Another Hospital

Volume (and Percentage) of All Patients from Scene or Transferred toParkview Trauma Centers2010 – 2014


County of Injury Occurrence in Catchment Area2014

Inference: Parkview Adult Trauma Center and Parkview Pediatric Trauma Center are regional referral trauma centers. As such, Parkview Trauma Centers received patients from these counties for treatment.

(623)

(90)

(103)(35) (1)

(21)

(65)

(12)(1)

(112)

(73)

(33)(6) (14)

(11)

(4)

(2)(14)(7)

(3)

(25)

(28)

(24)

(2)

(3)

(24)

(33)

(1)

(1)

(13)

(1)

(20)

(33)

(5)

(1)

(1)

RTTDC© is a copyrighted program of the American College of Surgeons. 35Outreach and Education I

Parkview Hospital Randallia

Parkview Hospital Randallia has been committed to the health and well-being of Allen County residents for decades, and it continues to be a center for healthcare excellence today. This facility was the original Parkview Trauma Center and still operates in the near-central portion of the City of Fort Wayne. Today, Parkview Randallia continues to be the busiest Emergency Department in the region. Whether providing care for traumatic or less-emergent injuries, physicians, nurses and other health professionals strive to provide excellent care to every patient every day.

Structurally, Parkview Randallia is undergoing renovation to better the environment in which patients experience rapid-fire diagnosis and treatment when visiting the hospital’s Emergency Department.

Parkview Huntington Hospital

Parkview Huntington Hospital has continued to advance the quality of trauma care with a team approach to traumatically injured individuals within the county. The hospital continues to monitor metrics for standards of

documentation and care. Trauma team activations allow the trauma team to rapidly assess and treat the injured patients to optimize their overall care. The collaboration of team members ensures that care for trauma patients at Parkview Huntington is optimized, as demonstrated by the metrics.

Collaborating with a dedicated orthopedic surgeon who practices in Huntington County enables the hospital care team to treat patients closer to home if they have isolated orthopedic injuries. The goal is to help patients remain within their own community for treatment whenever possible.

Parkview LaGrange Hospital

From vehicular crashes on the Indiana toll-road to Amish farm injures, Parkview LaGrange Hospital sees various types of trauma. Parkview LaGrange Hospital physicians and staff continue to demonstrate their commitment to providing the best possible care for injured patients.

The hospital has adopted trauma activation guidelines and collaborates with LaGrange County EMS to develop a systematic response to caring for injured patients. In 2014, LaGrange Emergency Department focused on transfer-out times of the severely injured patients. Parkview Samaritan’s flight and ground transport team plays a crucial role in these rapid transfers. When additional resources are needed, adult and pediatric trauma patients are transferred to the Level II Parkview Trauma Centers at Parkview Regional Medical Center in Fort Wayne.

LaGrange County has experienced an increase of serious accidents involving motor vehicles and people who are vulnerable due to their mode of transportation — horse-drawn buggy, bicycle or foot traffic. Amish and Plain Church community members now represent nearly 40 percent of the county’s population. Growth in the county’s Amish community and the heavy truck and tourist traffic often create dangerous situations. The hospital expanded the Share the Road trauma prevention campaign within the county in order to heighten awareness, promote safety for car and buggy travellers and decrease the number of life-changing traumatic injuries.

Jennifer Konger, RN, BSNCommunity Trauma Program Manager, Parkview Trauma Centers

COMMUNITY HOSPITALS

I Community Hospitals36

Parkview Noble Hospital

Parkview Noble Hospital staff members follow a systematic approach when traumatically injured patients arrive at the hospital. Such an approach is critical in order for patients to receive the most appropriate, quality care each time.

For patients with major trauma, the Emergency Department staff strives to work in a coordinated fashion with the pre-hospital professionals of EMS and their dispatchers, as well as other hospital-based providers. The Emergency Department personnel calls on team members in Lab, X-ray, Cardiopulmonary and other departments to assess and meet the needs of each trauma victim as rapidly as possible, just as they do for heart attacks and strokes. Under the medical direction of Terry Gaff, MD, the Emergency Department team does their best to provide every available resource for assessment and treatment immediately in these time-critical situations. For those who are injured, Parkview Noble Hospital Emergency Department steps

forward to be the patient’s trauma team.

Parkview Wabash Hospital

Parkview Wabash Hospital is the newest member of the Parkview family of community hospitals. The hospital is a 25-bed critical access hospital with a 24-hour Emergency Department. It’s a community-focused hospital with a commitment to excellent patient care. When trauma strikes in Wabash County, the Emergency Department team responds with speedy triage and expert care. Performance improvement efforts currently focus on Emergency Department length of stay. Quality goals are driven by achieving the best outcomes for local residents who need services.

Parkview Whitley HospitalThe staff of Parkview Whitley Hospital strives daily to provide excellent care to seriously injured patients. Hospital-based providers have taken steps to identify injuries quickly in order to facilitate appropriate disposition of injured patients.

The Parkview Whitley Emergency Department collaborates with EMS personnel in order to triage each patient according to the national standards. The hospital implemented documentation standards, trauma team activations and quality metrics. These efforts ensure that patients receive the best possible care and, ultimately, experience the best outcomes.

While each local hospital identifies its own performance improvement focus each year, all Parkview hospitals share a commitment to data collection and a team approach. Parkview’s community hospitals upload trauma data into the Indiana State Department of Health database, as well as the National Trauma Data Bank. As each hospital continues to measure process improvement and practice in accordance to national trauma guidelines, trauma patients receive excellent care throughout Parkview facilities. A vast network including local teams of physicians, nurses and ancillary departments work hand-in-hand with EMS and other first responders in order to achieve excellent trauma outcomes for individuals

experiencing life-threatening injuries.

Parkview Huntington Hospital EMS team members from left to right: Rick Uecker, Paramedic Supervisor Katrina (Katie) Adelman, Paramedic Isaac Martin, Advanced EMT

37Community Hospitals I

As the home of the Parkview Trauma Centers, Parkview Regional Medical Center (PRMC) has a robust emergency preparedness program. At its heart is a multidisciplinary team that meets monthly to discuss emergency codes and plan exercises. The team conducts several tabletop exercises each year with leadership, as well as a functional exercise for further education and training in the command center.

The in-house decontamination team, also comprising

a multidisciplinary group of staff members, conducts

quarterly “wet decon drills” to maintain their skills and

ensure that equipment is in proper working order. Each

year’s activities culminate in a full-scale exercise

using a scenario that is based upon the hazard

vulnerability analysis from the prior year. This

full-scale exercise involves multi-agency

coordination and patient influx, as well as

decontamination of live “victims.”

These efforts, drills and exercises assist the

Emergency Preparedness Team in building and

maintaining a comprehensive program for the

Parkview Regional Medical Center campus.

Facility design also contributes to preparedness

efforts. The decontamination system on the PRMC

campus comprises two distinct areas:

• Decontamination shower room — Directly

adjacent to the Emergency Department, this

shower room has four shower heads and a closed

containment tank system capable of holding up

to 300 gallons of run-off water. It can be used in

the event that several people or a small group of

ambulatory patients needs decontamination.

• Built-in shower system — Incorporated into

the EMS bay canopy outside the Emergency

Department, this shower system can potentially

be used for mass decontamination. The area

beneath the canopy can be set up in two separate

corridors to accommodate large groups of both

male and female victims.

In addition, an inflatable decontamination tent,

housed on the disaster trailer, provides a portable

third option. The tent can be transported and set

up on other areas of the campus, or off-campus,

should the PRMC’s Emergency Department

become contaminated or otherwise unsuitable for

patient care.

I Emergency Preparedness38

EMERGENCY PREPAREDNESS

Prevention I 39

PREVENTION

Trauma prevention programs reveal the Parkview Adult and Pediatric Trauma Centers’ continuing commitment to reducing the number of lives impacted by life-threatening injuries.

Don’t Text & Drive

Parkview’s Don’t Text & Drive (DT&D) campaign began

raising awareness about the dangers of distracted driving

years before national campaigns proliferated. Parkview

Trauma Centers have been deeply involved in the

program, which continues to mature year after year. The

program is an outreach to the community to help save

lives by raising public awareness.

Social media played a huge part in ongoing growth as

the Don’t Text & Drive campaign spread the word at local

and regional events, and the Facebook page featured

studies, videos and personal stories. The DT&D Facebook

page now has more than 157,000 followers and continued

support from all over the world.

Parkview added new billboards and transit advertising

with a thought-provoking message reminding adults that

they, too, should refrain from texting and driving: “Your

kids are watching.”

Parkview continues to collaborate with Evans Toyota, Fort

Wayne, and the Indiana State Police to share the messages

of the Don’t Text & Drive and Share the Road campaigns.

Don’t Text & Drive Seminars for Teens and Parents

Parkview Trauma Centers periodically sponsor free seminars

to help equip young drivers and their parents with the tools

they need to become more focused, safer drivers. Powerful

testimonials from people who have lost loved ones to

distracted driving crashes prompt frank conversation.

The Share the Road campaign promotes safety for all people using various modes of transportation in the region, and reminds motorists to be alert and allow plenty of room for more vulnerable, slower-moving travelers.

Laws governing distracted driving are also discussed,

and seminar participants experience the dangerous

nature of distracted driving firsthand while using a

driving simulator provided by AAA.

Share the Road

Parkview Trauma Centers have implemented the

growing Share the Road program to help protect

and prevent injuries within the community. With the

increased activity that is taking place on the road

systems, motorists and other travelers alike need

to become more alert and aware of the variety of

commuters. Parkview has been working closely with

the City of Fort Wayne to magnify the importance

of sharing the road with pedestrians, bicyclists,

motorcyclists, and Amish buggy passengers. Public

outreach includes billboards designed with runners,

motorcyclists, cyclists, and Amish buggies in mind. The

latest mobile advertisement for this program is the

Share the Road vehicle wrapped in artwork that helps

remind motorists to be aware.

Bike Helmet Safety and the Parkview Safety Store

The Parkview Safety Store located at Carew Medical

building offers injury-prevention merchandise and safety

supplies that will keep you safe at any age, from inside the

home to being outside. The store also provides

safety-certified bike helmets and fittings to ensure the

proper fit for each individual. Apparel and other items

supporting Parkview’s Don’t Text & Drive and Share the

Road campaigns are available for purchase at the store.

Parkview Safety Store

(260) 373-7201

1818 Carew Street, Suite 140

Parkview Hospital Randallia campus

Fort Wayne, IN 46805

Tuesdays, 10 a.m. – 1 p.m. and 4 – 7 p.m.

Members of the Public Attending Presentations/Program DisplaysProvision of Trauma Prevention Education Program

Don’t Drink and Drive1

Don’t Text & Drive2

Share theRoad3

1 Implemented in 1998 2 Began in 2009 3 Launched in 2010

11,351

5,185

19,822

Attendees

0 5,000 10,000 15,000 20,000

PREVENTION continued

I Prevention40

7445347

7194

143319

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Device Used* None Unknown

Motor Vehicle Crash

Motorcycle Crash

Moped Crash

ATV Crash

Bicycle Crash

*Note: Multiple devices used in a single vehicle crash are counted as one.

Protective Devices Used in Selected Crashes, All Trauma2014

131810

7145

Don’t Drink and Drive

In order to reduce the number of deaths and

severe, long-term disabilities from crashes due to

drinking and driving, Parkview Trauma Centers

offer free presentations and displays to schools

and community organizations. Presentations

offer a personal story involving loss of life due to

drunk driving. The very powerful presentations are

known for capturing the attention of even restless

teens. “Fatal vision” glasses are also available for

participants, enabling them to safely experience the

sensation of driving drunk to fully understand how

intoxication impairs vision and reflexes.

Multiplier Effect

Trauma prevention is a collaborative effort that

reaches across departments and disciplines. Parkview

Trauma Centers convened a task force to multiply the

impact of the range of programs aimed at reduction

of injuries. Trauma staff members and the prevention

specialist are available to provide education on all of

these programs.

Child Maltreatment Team

Parkview has initiated an expert team whose

members are available at a moment’s notice

when abuse, neglect or other maltreatment is

suspected. The trauma pediatric coordinator serves

as a liaison to the team, which includes child life

specialists and members from pediatric critical care,

pediatric emergency medicine, trauma surgery and

pediatric psychiatry.

Safe Sleep

In recent years, SIDS (Sudden Infant Death Syndrome)

has been linked to unsafe sleep practices such as

co-sleeping (infants sleeping with their parents in bed)

Prevention I 41

and suffocation from inappropriate bedding. Under the aegis

of Parkview’s Safe Slumber program, registered nurses from

Parkview Community Nursing educate parents-to-be on the

hazards of unsafe sleep practices and provide tips on creating

a safe sleep environment. The program also supplies cribs to

families who need a safe place for their infant to sleep.

Car Seat Safety

Parkview provides free car seat inspections to aid parents

in ensuring their children are properly restrained in safety-

approved car seats whenever they’re on the road. Inspections

are offered by appointment and at some community events.

ThinkFirst

Parkview helps elementary and high school students

recognize dangerous behaviors and avoid life-threatening or

permanently disabling injuries through ThinkFirst presentations

in the classroom.

ThinkFirst is a National Injury Prevention Foundation program,

and presentations are geared to specific age groups, with

subject matter for younger children aimed at encouraging use

of safety habits at an early age, and more serious discussion

for teens. Individuals who have suffered brain or spinal cord

injuries speak honestly with teens about risky behaviors and how

their lives have been impacted by paralysis or brain damage.

A rehab nurse facilitates discussion. Also covered are violence

prevention, dealing with peer pressure and bullying, and safety

in sports and recreation. Presentations are provided through

Parkview Rehabilitation Center — in partnership with Fort Wayne

Neurological Center — and Parkview Community Nursing.

Safety Camps

Parkview collaborates with emergency services providers

and health-and-wellness organizations in several counties

of its service area to provide one-day safety camps for

youngsters. Camp provides fun, interactive activities

that teach grade-school children about safety with

regard to water, fire, household hazards, recreation,

I Prevention42

PREVENTION continued

Prevention I 43

Total Tested BAC 0.08+

18449

6627

287

2211

1510

126

85

84

32

*Note: BAC equal to or greater than 0.08 is considered legally intoxicated.

Motor Vehicle Crash

Fall

Motorcycle Crash

Assault

Gunshot Wound

Pedestrian Struck

ATV Crash

Bicycle Crash

Stabbing

Blood Alcohol Concentration (BAC) Level in Selected Patients2014

0 40 80 120 140 160 180 20020 60 100

strangers and pets. They also give the children a chance to

learn about basic health topics and talk with first responders

and law enforcement officers.

Driver Rehabilitation

Medical conditions, effects of aging and other factors can

erode a person’s ability to safely operate a vehicle. Parkview

Outpatient Therapy’s Driver Rehabilitation program helps

older adults and others regain their driving skills and avoid

accidents. Occupational therapists, who are certified driver

rehab specialists, evaluate each person’s physical condition

and cognition, provide on-the-road driving assessments

and make recommendations for any education, equipment

or other resources needed. These may include driving

aids, behind-the-wheel training, vehicle modification and

alternative transportation.

Fall Prevention

Many older adults restrict their activities because they

are concerned about the possibility of falling. Indeed,

falls are among the most numerous injuries treated at

Parkview Trauma Centers. New in 2015, a designated

nurse practitioner now oversees a geriatric fall prevention

program to help better educate this population with

inpatient and outpatient follow-up.

Parkview Center on Aging & Health offers a fall prevention

program enabling patients to determine their risk for a fall.

In addition, Parkview Senior Services offers an eight-session

“A Matter of Balance” workshop that emphasizes practical

strategies for managing falls, such as eliminating household

tripping hazards and increasing activity levels.

First Class

U.S. POSTAGE

PAIDFORT WAYNE, IN

PERMIT NO. 1441

Parkview Health

10501 Corporate Drive

Fort Wayne, IN 46845

Raymond Cava, MD, FACS, Trauma Medical Director, Pediatric Trauma Medical Director and Pediatric ICU Co-medical Director, Parkview Regional Medical Center; and Acute Care/Trauma Surgeon, Parkview Physicians Group — Surgical Specialists

Joseph C. Muller, MD, FACS, Surgical/Trauma ICU Medical Director, Parkview Regional Medical Center; and Acute Care/Trauma Surgeon, Parkview Physicians Group — Surgical Specialists

Richard A. Falcone, Jr., MD, MPH, Pediatric Trauma Consultant, Parkview Pediatric Trauma Center; and Pediatric Trauma Medical Director, Cincinnati Children’s Hospital Medical Center

Lisa Hollister, RN, BSN, Director, Trauma and Acute Care Surgery

Tabitha Bane, NP, Geriatric Fracture Coordinator

Roxanne Barnes, RN, BSN, Trauma Program Nurse

Debbie Hawkins, RN, BSN, Trauma Program Nurse

Sarah Hoeppner, RN, BSN, Adult Trauma Coordinator and Trauma Performance Improvement Specialist

Diane Hunt, Trauma Administrative Assistant

Kellie Girardot, RN, BSN, Pediatric Trauma Coordinator

Jennifer Konger, RN, BSN, Manager, Community Trauma Program

Dazar Opoku, MPH, Trauma Data Specialist

Chris Scheumann, RN, BSN, CCRN, CEN, NREMT-P, PI, Trauma Outreach Coordinator

Britney Schwartz, RN, BSN, Injury Prevention Specialist

Thein Hlaing Zhu, MB BS, DPTM, FRCP, FACE, Trauma Epidemiologist

TRAUMA SERVICES TEAM

Documents

PARKVIEW TRAUMA 2015 · 2019-10-24 · 2014* (n=1794) Note: Thirteen cases were not admitted; these patients either expired or transferred out from the Emergency Department. * Excludes